Sympathomimetics in veterinary species under anesthesia

Skelding, Alicia; Valverde, Alexander

doi:10.1016/j.tvjl.2020.105455

Cited by 5 publications

(19 citation statements)

References 62 publications

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“…13,27 Noradrenaline is reported to have similar adrenergic agonist activity to dopamine acting via β1 and α1 receptors likely explaining the similar effects on CO, SVR and untimely improved BP seen in the studies in this CAT. 34 Unlike the some of the studies evaluating dopamine neither noradrenaline study reported UoP or other renal parameters preventing any comparison of the renal effects of these two drugs. 13,27 Currently there are no studies directly comparing noradrenaline and dopamine for treating hypotension in dogs.…”

Section: Critical Appraisal Of the Evidencementioning

confidence: 96%

“…One study also demonstrated dopamine improved UoP suggesting increased renal blood flow and glomerular filtration rate (GFR) 33 . Dopamine is reported to have dose dependant effects on the cardiovascular system, at lower doses acting via dopamine (DA1) receptors predominately in renal vasculature, with further effects exerted via β1 and finally α1 adrenergic receptors with progressively higher doses thus increasing CO and SVR, respectively 34 . Studies in this review predominately used mid‐range dopamine (Table 4 – Studies 2, 3, 4, 5, 9 and 11) starting infusions at 7 μg/kg/min 12,22,31 or 5 μg/kg/min 30,32 and increasing up to 10 to 15 μg/kg/min.…”

Section: Critical Appraisal Of the Evidencementioning

confidence: 99%

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What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane?

Quinn

2024

Aust Veterinary J

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Hypotension is a common and potentially life‐threatening complication of general anaesthesia in dogs. Due to the combination of cardiovascular side effects of many anaesthetic, sedative and analgesic drugs used peri‐operatively hypotension is frequently reported even in healthy dogs undergoing elective procedures. Several treatment options for hypotension have been advocated. Potential treatments include rapid administration of either crystalloid or colloid fluids; pharmacological treatments to increase cardiac output and/or systemic vascular resistance; or reduction in the delivery of the volatile anaesthetic agents. This critical appraisal considers the current evidence for which treatment is the best option for treating hypotension in healthy euvolemic dogs undergoing general anaesthesia maintained with isoflurane. Fourteen relevant studies were appraised, including 12 laboratory studies and two small clinical trials. One study demonstrated that reduction in the delivery of isoflurane may correct hypotension, but this treatment may not always be feasible. In general, rapid administration of fluids did not increase blood pressure and failed to correct hypotension. Synthetic colloids demonstrated some efficacy, but results were inconsistent between studies and large volumes may be required. Infusion of dopamine appears to be the most reliable pharmacological option consistently increasing blood pressure, cardiac output and correcting hypotension.

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Section: Critical Appraisal Of the Evidencementioning

confidence: 96%

Section: Critical Appraisal Of the Evidencementioning

confidence: 99%

What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane?

Quinn

2024

Aust Veterinary J

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“…Dopamine is less efficient at normalizing arterial blood pressure than norepinephrine and it has been associated with arrhythmias than norepinephrine (42), most likely because vasoconstrictor effects of dopamine are achieved with higher infusion rates, which also exacerbate beta-1 adrenergic effects (81). In addition, mortality is higher than in patients receiving norepinephrine (42).…”

Section: Vasopressorsmentioning

confidence: 99%

“…Phenylephrine is a pure alpha-1 agonist; therefore only vasoconstriction is expected from it, which may be detrimental in hypovolemic patients that also exhibit a reduction in cardiac output, unless contractility is supported with beta-1 agonists (81). Septic patients treated with phenylephrine had a higher mortality rate than patients treated with norepinephrine (82) and current recommendations from the guidelines for management of sepsis and septic shock state that phenylephrine use should be limited until more research is available (72).…”

Section: Vasopressorsmentioning

confidence: 99%

“…Standard doses of sympathomimetics and vasopressin used to treat hypotension include 1-10 µg/kg/min for dopamine, 1-10 µg/kg/min for dobutamine, 0.1-2 µg/kg/min for norepinephrine, 0.05-0.1 µg/kg/min for epinephrine, 0.5-2 µg/kg/min for phenylephrine, and 0.3-5 mU/kg/min for vasopressin (81). In human patients with refractory hypotension, higher doses than those mentioned above for each of these drugs are often necessary in attempts to manage their cardiovascular derangement (41,42,86); from a prognostic point of view, the need for higher doses of vasopressors is associated with unfavorable outcomes (41,86).…”

Section: Vasopressorsmentioning

confidence: 99%

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Fluid Resuscitation for Refractory Hypotension

Valverde

2021

Front. Vet. Sci.

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Hypotension is a common occurrence, especially in anesthetized patients and in critical patients suffering from hypovolemia due to shock and sepsis. Hypotension can also occur in normovolemic animals, anesthetized or conscious, under conditions of vasodilation or decreased cardiac function. The main consequence of hypotension is decreased organ perfusion and tissue injury/dysfunction. In the human literature there is no consensus on what is the threshold value for hypotension, and ranges from < 80 to < 100 mmHg for systolic blood pressure and from < 50 to < 70 mmHg for mean arterial blood pressure have been referenced for intraoperative hypotension. In veterinary medicine, similar values are referenced, despite marked differences in normal arterial blood pressure between species and with respect to humans. Therapeutic intervention involves fluid therapy to normalize volemia and use of sympathomimetics to enhance cardiac function and regulate peripheral vascular resistance. Despite these therapeutic measures, there is a subset of patients that are seemingly refractory and exhibit persistent hypotension. This review covers the physiological aspects that govern arterial blood pressure control and blood flow to tissues/organs, the pathophysiological mechanisms involved in hypotension and refractory hypotension, and therapeutic considerations and expectations that include proper interpretation of cardiovascular parameters, fluid recommendations and therapy rates, use of sympathomimetics and vasopressors, and newer approaches derived from the human literature.

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Sympathomimetics and Vasopressin

Lerche

2024

Pharmacology in Veterinary Anesthesia and Analgesia

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Sympathomimetics in veterinary species under anesthesia

Cited by 5 publications

References 62 publications

What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane?

What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane?

Fluid Resuscitation for Refractory Hypotension

Sympathomimetics and Vasopressin

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